Introduction
Interdisciplinary collaboration is a broad concept that is used in a variety of backgrounds, including nursing practice, social work, and the arts. Interdisciplinary collaboration is also important to leadership in healthcare, as interdisciplinary teams require insightful and creative leadership to function successfully. Despite the fact that the term refers to a specific concept that is applied in a similar way in a variety of cases, few efforts have been undertaken to define its key attributes and establish a definition. A concept analysis can help to address these gaps and outline the function and structure of interdisciplinary collaboration to promote its correct application and management in healthcare.
Aim and Purpose of Concept Analysis
According to Walker and Avont (2011), concepts are mental constructions used to represent information containing certain defining attributes. However, whereas some simple concepts are easy to define, others are broader and can be used differently depending on the exact setting. Interdisciplinary collaboration is a rather vague concept; although most users understand its meaning and application, they might fail to define its structure and function. Vagueness and ambiguity impair theory construction, as the concept lacks an operational base (Walker & Avont, 2011). Theory construction, on the other hand, is crucial to the research and improvement of practices that can enhance the outcome of interdisciplinary collaboration in healthcare. Thus, the purpose of the present concept analysis is to address the existing gaps in the definition of interdisciplinary collaboration, thus enhancing the use of the practice in research and care. The present paper aims to outline the main uses of the concept in order to determine its defining attributes, as well as to establish empirical referents and provide examples of cases.
Uses of Concept
According to the Cambridge English Dictionary, collaboration is “the situation of two or more people working together to create or achieve the same thing” (“Collaboration,” 2017, para. 1). In the political context, collaboration can also be used to identify the process of conspiring with an enemy (“Collaboration,” 2017). Interdisciplinarity, on the other hand, refers to “the integration of concepts, philosophies, and methodologies from different fields of knowledge” (Derry, Schumm, & Gernsbacher, 2014, p. xiii). Thus, in its primary sense, interdisciplinary collaboration can be defined as the situation of two or more people working together to integrate concepts, philosophies, and methodologies from different areas of knowledge to achieve a common goal. Examples of interdisciplinary collaboration can be found in education, research, social work, healthcare, and the arts. For instance, social workers are required to work together with colleagues from other disciplines to provide comprehensive care and services to those in need (Bronstein, 2003). Bronstein (2003) defines five key attributes of interdisciplinary collaboration in social work: “interdependence, newly created professional activities, flexibility, collective ownership of goals, and reflection on the process” (p. 297). Bronstein’s (2013) definition of interdisciplinary collaboration is thus effective, as it provides the defining attributes of this concept from the perspective of a social worker. Barthel and Seidl (2017) study the concept of interdisciplinary collaboration in research. The researchers use the term to refer to the collaboration between natural and social scientists, stating that such collaboration is crucial to solving many challenges faced by scientists in today’s world (Barthel & Seidl, 2017). They refer to previous literature to distinguish interdisciplinary collaboration from other forms of collaboration, such as cross-disciplinary, multidisciplinary, and transdisciplinary. By Barthel and Seidl (2017) Interdisciplinary collaboration is the process of addressing an issue or problem that encompasses a variety of disciplines to achieve a comprehensive understanding of it. As opposed to Bronstein (2013), Barthel and Seidl (2017) do not specify working towards a common goal as an important characteristic of interdisciplinary collaboration, although they state that it applies to multidisciplinary collaboration, which is focused on joint problem-solving. Interdisciplinary collaboration in the arts is rarely addressed and refers mainly to the process of cooperation between different types of professionals to achieve a single creative goal. For instance, film production is a good example of interdisciplinary collaboration in the arts, as it involves a wide variety of professionals in different occupations working together to produce the end product. Steinheider and Legrady (2004) attempt to define interdisciplinary collaboration in digital media arts, determining three key processes that characterize it: communication, coordination and the sharing of knowledge.
Nevertheless, the vast number of studies on interdisciplinary collaboration apply to the use of this concept in healthcare settings. Indeed, nurses and doctors face the need to collaborate with others on a daily basis to produce diagnoses, treat, and monitor patients. Fewster-Thuente and Velsor-Friedrich (2008) define interdisciplinary collaboration in nursing as a process that brings together two or more individuals from different professional disciplines to work for shared aims and objectives. The researchers also provide the defining attributes of such collaboration based on previous research definitions, such as shared power based on knowledge, lack of hierarchy, open communication, negotiation, coordination, shared planning and decision-making (Fewster-Thuente & Velsor-Friedrich, 2008). Petri (2010) performed a concept analysis of interdisciplinary collaboration in healthcare, referring to it as an interactional or an interpersonal process focused on the use of knowledge from multiple disciplines to solve a complex problem. Similarly, Henneman, Lee, and Cohen (1995) defined interdisciplinary collaboration as a partnership or union between professionals from different fields of knowledge based on common goals and mutual commitments. Henneman et al. (1995) also stressed that, although the dictionary definition of collaboration as working with an enemy appears unrelated to healthcare, “collaboration in health care frequently is used in reference to the relationship between two, sometimes adversarial groups, namely physicians and nurses” (p. 104). Interdisciplinary collaboration in clinical research and practice is also addressed by VanWormer, Lindquist, Robiner, and Finkelstein (2012). The researchers examine interdisciplinary collaboration in lung transplantation, viewing it as “working together with others toward mutually agreed upon goals for a specified purpose or project” (p. 203). Finally, Nancarrow et al. (2013) address the process of interdisciplinary collaboration in healthcare settings to establish ten principles leading to successful collaboration. The researchers use the term to define “a complex process in which different types of staff work together to share expertise, knowledge, and skills to impact on patient care” (Nancarrow et al., 2013, p. 19). In addressing the characteristics that define effective interdisciplinary collaboration, Nancarrow et al. (2013) refer to attributes such as appropriate skill mix, role division, positive team climate, and efficient communication strategies.
Defining Attributes
Based on the review of the literature, interdisciplinary collaboration both in healthcare and in other fields of work can be defined in terms of several distinctive attributes.
Firstly, all the provided definitions of collaboration stress that it involves two or more people from various professional disciplines working together. By definition, this is the basic characteristic of interdisciplinary collaboration, and it can be applied to the process regardless of its context.
Secondly, most of the definitions stressed the importance of a common goal (Nancarrow et al., 2013; VanWormer et al., 2012; Petri, 2010). Indeed, in the context of health care, interdisciplinary collaboration is crucial to achieving good patient outcomes, which requires participants to work on diagnostics or treatment together.
Thirdly, although Fewster-Thuente and Velsor-Friedrich (2008) stress the non-hierarchal nature of interdisciplinary collaboration, it is still a controlled process. As noted by Nancarrow et al. (2013), effective leadership and management are essential to successful interdisciplinary collaboration. Although collaboration teams might not always have a single leader in place, the collaboration is still guided by set procedures and standards.
Knowledge sharing is another important characteristic of interdisciplinary collaboration. The need for collaboration across disciplines arises when the knowledge of a single professional is not sufficient to address a problem; therefore, knowledge sharing between professionals from various disciplines should be viewed as one of the defining attributes of the process.
Communication also seems to be among the defining attributes of interdisciplinary collaboration in all fields of knowledge (Steinheider & Legrady, 2004; Fewster-Thuente & Velsor-Friedrich, 2008; Petri, 2010). Interactions between participants are crucial, as they enable knowledge sharing and facilitate the process of working towards common goals.
Finally, shared responsibility was also highlighted in several definitions of interdisciplinary collaboration in healthcare provided above (Fewster-Thuente & Velsor-Friedrich, 2008; Petri, 2010; Henneman et al., 1995; Nancarrow et al., 2013). Shared responsibility is closely associated with the non-hierarchal nature of collaboration and with knowledge sharing. When providing a knowledge input to meet a collective goal, participants thus assume responsibility for part of the outcome.
Based on the above attributes, interdisciplinary collaboration in healthcare is a guided process where two or more professionals share their knowledge and expertise in various disciplines using interpersonal communication to achieve a shared goal.
Cases
Model
A model case represents the instance where all the defining attributes of the concept can be observed (Walker & Avont, 2011). One case of interdisciplinary collaboration that occurs in clinical care on a daily basis is the diagnosis and treatment of patients by nurses and doctors. These processes require doctors and nurses to work together to achieve a common goal of improving the patient’s condition. Such collaboration is always guided by applicable clinical practice standards, as well as by internal regulations existing in a hospital. The process also implies interpersonal communication and knowledge sharing as doctors and nurses have a variety of skills, experiences, and knowledge needed to promote the patient’s recovery. Finally, doctors and nurses share the responsibility for the patient’s recovery. For instance, doctors are responsible for determining the diagnosis and prescribing treatment, whereas nurses are responsible for conducting the prescribed procedures. Another model case of interdisciplinary collaboration in health care that contains all the defining attributes of the concept is telemedicine. Telemedicine involves remote diagnosis and treatment of conditions that require the efforts of multiple professionals working in different disciplines. Similarly, telemedicine is characterized by shared goals and responsibility and is conducted in accordance with set procedures. Knowledge sharing is the primary goal of telemedicine, as it was designed to provide access to the knowledge and expertise of healthcare professionals working in other geographical areas. Communication via telecommunications technology is a defining feature of telemedicine, meaning that it also possesses a communication component.
Borderline
Borderline cases are examples that contain most of the defining attributes but differ substantially in at least one of them (Walker & Avont, 2011). The collaboration of nurses in clinical settings is a borderline example of interdisciplinary collaboration. It includes communication of knowledge, is driven by the end goal of helping patients, and is guided by appropriate standards and managed by an internal hierarchy. Nurses who work together share the responsibility for the patient’s progress and recovery. However, this case lacks the interdisciplinarity component, which makes it borderline with interdisciplinary collaboration.
Related
According to Walker and Avont (2011), related cases are “instances of concepts that are related to the concept being studied but that do not contain all the defining attributes” (p. 165). In the present case, a related example of interdisciplinary collaboration is the education of interns in clinical settings. Although this case involves common goals and communication and is carried out in accordance with set regulations and schemes, it differs in terms of knowledge sharing. In model cases of interdisciplinary collaboration, knowledge is shared by all the participants; in education, on the other hand, knowledge is transferred from highly experienced professionals, such as registered nurses and physicians, to students whose experience is still limited. Moreover, the share of responsibility between the interns and nurses or physicians is usually unequal. Thus, intern education is a related case of interdisciplinary collaboration.
Contrary
A contrary case of interdisciplinary collaboration is the diagnosis and treatment of a patient by a single medical practitioner. There are many cases when a patient is seen by one doctor or nurse who establishes the diagnosis and prescribes medication. Pharmacists, laboratory workers, and other healthcare workers are not directly involved in the diagnosis and treatment process, which is why there is no interdisciplinary communication.
Another case that can be viewed as contrary to interdisciplinary collaboration as defined in this analysis is secondary research. For instance, a student reviewing previous research studies on the topic and using some of the knowledge in his or her own work can be seen as an example of knowledge sharing. Moreover, the use of secondary research by students is controlled by set procedures, including plagiarism avoidance and checks. However, this case cannot be viewed as borderline or related to interdisciplinary collaboration, as no communication, shared responsibility, or common goals are evident.
Illegitimate
An illegitimate case describes an instant when a concept is used improperly or out of context (Walker & Avont, 2011). Although the case might involve some of the defining attributes of the concept, it cannot be described as a related or borderline case, as it differs significantly from the main concept. In the case of interdisciplinary collaboration, it is difficult to find an example of the use of this term that is completely inapplicable to the definition provided in the present concept analysis. However, it is possible to find an illegitimate case of the use of the term “collaboration,” as identified in the previous sections. In the political context, collaboration defines traitorous cooperation with an enemy (“Collaboration,” 2017). It is only used in a negative way and has a meaning similar to “treason” or “conspiracy,” which makes it completely irrelevant to the healthcare context. In inpatient care, any kind of collaboration serves a positive end goal, such as improving the patient’s condition, enhancing services, or developing new treatment options. Thus, even though Henneman et al. (1995) state that the presence of adversarial groups involved in interdisciplinary collaboration links it to the negative interpretation of the word, the concept of collaboration as used in the present concept analysis cannot be used in a negative way, which makes political collaboration irrelevant to it.
Antecedents and Consequences
Defining antecedents and consequences of a concept is a critical step in analyzing it, as these features can help to define the context in which a particular concept is used (Walker & Avont, 2011). Antecedents are the features of context that allow the concept to occur; they are different from defining attributes in that they must already be in place before the process occurs (Walker & Avont, 2011). Consequences, on the contrary, are the effects resulting from the occurrence of the concept (Walker & Avont, 2011).
Antecedents
Interdisciplinary collaboration is a complex process that involves many considerations and thus has many important antecedents. First of all, the existence of a broad or complex problem that cannot be solved by a single professional is the primary antecedent of interdisciplinary collaboration. If the problem or issue is not complex enough, it can be managed by a single specialist or by a group of specialists working in the same field; thus, there are no grounds for interdisciplinary collaboration. The second antecedent of interdisciplinary collaboration is the possibility of communication between professionals from different knowledge areas. This is apparent in the model cases used to illustrate the concept. In the first model case, nurses and doctors work in the same hospital, and thus they can meet and communicate with one another. In the case of telemedicine, on the other hand, the existence of telecommunication technologies allows for the occurrence of interdisciplinary collaboration. Thirdly, interdisciplinary collaboration requires the presence of guiding and control mechanisms, or at least an opportunity for their development. As noted by Petri (2010), organizational and administrative support of interdisciplinary collaboration is crucial to ensure the occurrence of the process. Finally, the existence of knowledge is an important antecedent of interdisciplinary collaboration as defined in the present concept analysis. In order for the process to occur, it is critical to ensure that there are professionals who have the necessary knowledge to work on resolving the problem. Knowledge sharing is an important component of interdisciplinary collaboration, which is why the existence of knowledge that can be shared with other professionals is essential.
Consequences
The consequences of interdisciplinary collaboration in healthcare have been widely studied in research. For instance, Petri (2010) argues that interdisciplinary collaboration leads to increased quality of patient care and promotes better health outcomes. Moreover, it can improve organizational functioning, as it could potentially reduce costs by improving the efficiency of services or processes (Petri, 2010). Interdisciplinary collaboration can also help to enhance organizational climate by creating a supportive environment and giving employees a sense of common accomplishment (Henneman et al., 1995). Interdisciplinary collaboration also affects individual participants. For instance, it can help workers to improve communication skills and provide them with useful knowledge in an unfamiliar subject. Furthermore, interdisciplinary collaboration promotes confidence and a feeling of self-worth, thus also improving work satisfaction (Henneman et al., 1995). Finally, interdisciplinary collaboration affects healthcare on a global level. For example, a collaboration between scientists and medical personnel can help to create new technologies and treatments that would assist in addressing important health issues.
Empirical Referents
Empirical referents for interdisciplinary collaboration are tightly connected to its defining attributes. First, interdisciplinary collaboration can be measured using the number of participants and knowledge areas involved. Complex interdisciplinary collaboration cases can involve multiple knowledge areas, whereas more simple cases only include two or three, as in the first model case. Secondly, interdisciplinary collaboration can be measured by the number of meaningful interactions between the participating staff (Henneman et al., 1995). A low number of interactions is not characteristic of interdisciplinary collaboration and might indicate a borderline or related case. As indicated by Henneman et al. (1995), collaborative practice scales might also be used as empirical referents in formulating theory regarding interdisciplinary collaboration. Finally, another empirical referent for interdisciplinary collaboration is the use of “we”-statements (Henneman et al., 1995). In an interdisciplinary collaboration, professionals work together to achieve a common goal and thus should have a sense of collaborative achievement.
Conclusion
Overall, interdisciplinary collaboration in healthcare is a complex phenomenon that encompasses an entire variety of characteristics. The present concept analysis attempted to clarify the definition of interdisciplinary collaboration by focusing on its most essential features, as well as to illustrate the use of this definition in practice. Enhancing the clarity of definition might assist in developing appropriate theories and producing research studying the application of the concept in healthcare, which can help leaders to facilitate and manage interdisciplinary collaboration. Improving the leaders’ understanding of interdisciplinary collaboration, on the other hand, might help to improve its efficiency in improving patient and organizational outcomes. Due to the advancement of communication technologies and globalization, developing a comprehensive understanding of the structure and function of interdisciplinary collaboration is essential to ensuring the evolution of healthcare on a global scale.
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